Effects of excitatory transcranial magnetic stimulation over the different cerebral hemispheres dorsolateral prefrontal cortex for post-stroke cognitive impairment: a systematic review and meta-analysis
BackgroundPost-stroke cognitive impairment (PSCI) is a significant health concern. Transcranial magnetic stimulation (TMS) is considered a promising rehabilitation therapy for improving cognition, and the effects of excitatory TMS on PSCI have received much attention in recent years. However, the ef...
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| Format: | Article |
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Frontiers Media S.A.
2023-05-01
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| Series: | Frontiers in Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnins.2023.1102311/full |
| _version_ | 1797826347057283072 |
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| author | Kaiyue Han Kaiyue Han Jiajie Liu Jiajie Liu Zhiqing Tang Zhiqing Tang Wenlong Su Wenlong Su Wenlong Su Ying Liu Ying Liu Haitao Lu Haitao Lu Hao Zhang Hao Zhang Hao Zhang Hao Zhang |
| author_facet | Kaiyue Han Kaiyue Han Jiajie Liu Jiajie Liu Zhiqing Tang Zhiqing Tang Wenlong Su Wenlong Su Wenlong Su Ying Liu Ying Liu Haitao Lu Haitao Lu Hao Zhang Hao Zhang Hao Zhang Hao Zhang |
| author_sort | Kaiyue Han |
| collection | DOAJ |
| description | BackgroundPost-stroke cognitive impairment (PSCI) is a significant health concern. Transcranial magnetic stimulation (TMS) is considered a promising rehabilitation therapy for improving cognition, and the effects of excitatory TMS on PSCI have received much attention in recent years. However, the effects of different cerebral hemispheres on excitatory TMS treatment of cognitive impairment have not been studied. This review aimed to study the effects of excitatory TMS over the dorsolateral prefrontal cortex (DLPFC) of different cerebral hemispheres on the cognitive function of patients with PSCI.MethodsLiterature published in PubMed, Web of Science, Embase, Cochrane Library, Scopus, and Wiley from inception to September 30, 2022, were searched. Two researchers independently performed literature screening, data extraction, and quality assessment. Furthermore, we conducted a meta-analysis using RevMan software (version 5.4) and rated the strength of evidence using GRADEpro.ResultsA total of 19 studies were included in this meta-analysis. The results showed that excitatory TMS over the left hemisphere DLPFC was significantly better in improving global cognition (SMD = 2.26, 95% CI 1.67–2.86, P < 0.00001; vs. SMD = 2.53, 95% CI 1.86–3.20, P < 0.00001), memory (SMD = 1.29, 95% CI 0.72–1.87, P < 0.0001), attention (SMD = 2.32, 95% CI 1.64–3.01, P < 0.00001), executive (SMD = 0.64, 95% CI 0.21–1.07, P = 0.004), P300 latency (SMD = 2.69, 95% CI 2.13–3.25, P < 0.00001), and depression (SMD = 0.95, 95% CI 0.26–1.63, P = 0.007) than that of the control group, but the effect on improving activities of daily living (ADL) was unclear (P = 0.03 vs. P = 0.17). Subgroup analysis further showed that excitatory TMS over the right hemisphere DLPFC was effective in improving the global cognition of PSCI patients (P < 0.00001), but the stimulation effect over the ipsilateral hemisphere DLPFC was unclear (P = 0.11 vs. P = 0.003). Additionally, excitatory TMS over the ipsilateral hemisphere DLPFC showed no statistical difference in improving ADL between the two groups (P = 0.25).ConclusionsCompared to other hemispheric sides, excitatory TMS over the left hemisphere DLPFC was a more effective stimulation area, which can significantly improved the global cognitive function, memory, attention, executive, P300 latency, and depression in patients with PSCI. There was no apparent therapeutic effect on improving activities of daily living (ADL). In the future, more randomized controlled trials with large-sample, high quality, and follow-up are necessary to explore a usable protocol further.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022369096. |
| first_indexed | 2024-04-09T12:31:15Z |
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| institution | Directory Open Access Journal |
| issn | 1662-453X |
| language | English |
| last_indexed | 2024-04-09T12:31:15Z |
| publishDate | 2023-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neuroscience |
| spelling | doaj.art-6178f7826a70410faa16199e78cd7f622023-05-16T04:48:15ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2023-05-011710.3389/fnins.2023.11023111102311Effects of excitatory transcranial magnetic stimulation over the different cerebral hemispheres dorsolateral prefrontal cortex for post-stroke cognitive impairment: a systematic review and meta-analysisKaiyue Han0Kaiyue Han1Jiajie Liu2Jiajie Liu3Zhiqing Tang4Zhiqing Tang5Wenlong Su6Wenlong Su7Wenlong Su8Ying Liu9Ying Liu10Haitao Lu11Haitao Lu12Hao Zhang13Hao Zhang14Hao Zhang15Hao Zhang16School of Rehabilitation, Capital Medical University, Beijing, ChinaChina Rehabilitation Research Center, Beijing Bo'ai Hospital, Beijing, ChinaSchool of Rehabilitation, Capital Medical University, Beijing, ChinaChina Rehabilitation Research Center, Beijing Bo'ai Hospital, Beijing, ChinaSchool of Rehabilitation, Capital Medical University, Beijing, ChinaChina Rehabilitation Research Center, Beijing Bo'ai Hospital, Beijing, ChinaSchool of Rehabilitation, Capital Medical University, Beijing, ChinaChina Rehabilitation Research Center, Beijing Bo'ai Hospital, Beijing, ChinaUniversity of Health and Rehabilitation Sciences, Qingdao, ChinaSchool of Rehabilitation, Capital Medical University, Beijing, ChinaChina Rehabilitation Research Center, Beijing Bo'ai Hospital, Beijing, ChinaSchool of Rehabilitation, Capital Medical University, Beijing, ChinaChina Rehabilitation Research Center, Beijing Bo'ai Hospital, Beijing, ChinaSchool of Rehabilitation, Capital Medical University, Beijing, ChinaChina Rehabilitation Research Center, Beijing Bo'ai Hospital, Beijing, ChinaUniversity of Health and Rehabilitation Sciences, Qingdao, ChinaCheeloo College of Medicine, Shandong University, Jinan, ChinaBackgroundPost-stroke cognitive impairment (PSCI) is a significant health concern. Transcranial magnetic stimulation (TMS) is considered a promising rehabilitation therapy for improving cognition, and the effects of excitatory TMS on PSCI have received much attention in recent years. However, the effects of different cerebral hemispheres on excitatory TMS treatment of cognitive impairment have not been studied. This review aimed to study the effects of excitatory TMS over the dorsolateral prefrontal cortex (DLPFC) of different cerebral hemispheres on the cognitive function of patients with PSCI.MethodsLiterature published in PubMed, Web of Science, Embase, Cochrane Library, Scopus, and Wiley from inception to September 30, 2022, were searched. Two researchers independently performed literature screening, data extraction, and quality assessment. Furthermore, we conducted a meta-analysis using RevMan software (version 5.4) and rated the strength of evidence using GRADEpro.ResultsA total of 19 studies were included in this meta-analysis. The results showed that excitatory TMS over the left hemisphere DLPFC was significantly better in improving global cognition (SMD = 2.26, 95% CI 1.67–2.86, P < 0.00001; vs. SMD = 2.53, 95% CI 1.86–3.20, P < 0.00001), memory (SMD = 1.29, 95% CI 0.72–1.87, P < 0.0001), attention (SMD = 2.32, 95% CI 1.64–3.01, P < 0.00001), executive (SMD = 0.64, 95% CI 0.21–1.07, P = 0.004), P300 latency (SMD = 2.69, 95% CI 2.13–3.25, P < 0.00001), and depression (SMD = 0.95, 95% CI 0.26–1.63, P = 0.007) than that of the control group, but the effect on improving activities of daily living (ADL) was unclear (P = 0.03 vs. P = 0.17). Subgroup analysis further showed that excitatory TMS over the right hemisphere DLPFC was effective in improving the global cognition of PSCI patients (P < 0.00001), but the stimulation effect over the ipsilateral hemisphere DLPFC was unclear (P = 0.11 vs. P = 0.003). Additionally, excitatory TMS over the ipsilateral hemisphere DLPFC showed no statistical difference in improving ADL between the two groups (P = 0.25).ConclusionsCompared to other hemispheric sides, excitatory TMS over the left hemisphere DLPFC was a more effective stimulation area, which can significantly improved the global cognitive function, memory, attention, executive, P300 latency, and depression in patients with PSCI. There was no apparent therapeutic effect on improving activities of daily living (ADL). In the future, more randomized controlled trials with large-sample, high quality, and follow-up are necessary to explore a usable protocol further.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022369096.https://www.frontiersin.org/articles/10.3389/fnins.2023.1102311/fullstroketranscranial magnetic stimulationdorsolateral prefrontal cortexcognitive functionmeta-analysis |
| spellingShingle | Kaiyue Han Kaiyue Han Jiajie Liu Jiajie Liu Zhiqing Tang Zhiqing Tang Wenlong Su Wenlong Su Wenlong Su Ying Liu Ying Liu Haitao Lu Haitao Lu Hao Zhang Hao Zhang Hao Zhang Hao Zhang Effects of excitatory transcranial magnetic stimulation over the different cerebral hemispheres dorsolateral prefrontal cortex for post-stroke cognitive impairment: a systematic review and meta-analysis Frontiers in Neuroscience stroke transcranial magnetic stimulation dorsolateral prefrontal cortex cognitive function meta-analysis |
| title | Effects of excitatory transcranial magnetic stimulation over the different cerebral hemispheres dorsolateral prefrontal cortex for post-stroke cognitive impairment: a systematic review and meta-analysis |
| title_full | Effects of excitatory transcranial magnetic stimulation over the different cerebral hemispheres dorsolateral prefrontal cortex for post-stroke cognitive impairment: a systematic review and meta-analysis |
| title_fullStr | Effects of excitatory transcranial magnetic stimulation over the different cerebral hemispheres dorsolateral prefrontal cortex for post-stroke cognitive impairment: a systematic review and meta-analysis |
| title_full_unstemmed | Effects of excitatory transcranial magnetic stimulation over the different cerebral hemispheres dorsolateral prefrontal cortex for post-stroke cognitive impairment: a systematic review and meta-analysis |
| title_short | Effects of excitatory transcranial magnetic stimulation over the different cerebral hemispheres dorsolateral prefrontal cortex for post-stroke cognitive impairment: a systematic review and meta-analysis |
| title_sort | effects of excitatory transcranial magnetic stimulation over the different cerebral hemispheres dorsolateral prefrontal cortex for post stroke cognitive impairment a systematic review and meta analysis |
| topic | stroke transcranial magnetic stimulation dorsolateral prefrontal cortex cognitive function meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fnins.2023.1102311/full |
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